Individual
KELLIE RICHELLE SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
535 E MAIN ST, GRAYSON, KY 41143-1444
(606) 369-6218
(606) 217-6087
Mailing address
535 E MAIN ST, GRAYSON, KY 41143-1444
(606) 369-6218
(606) 217-6087
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010258
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0170248
—
OH
05
—
7100419400
—
KY
Enumeration date
06/01/2016
Last updated
08/10/2026
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